Funds are requested to support statewide, systematic investigations of health and developmental outcomes for a priority population of vulnerable young children who are primarily minority group members and who are at biological and socioenvironmental risk. These children have received early, preventive services at primary care community clinics of LSU Health Sciences Center. In category I, the specific aim is to formalize structures and enhance standardization of practices in a new, interdisciplinary pediatric primary care research network. The long-term objective of the network, termed CUBS, is to develop a statewide, outcome-focused database system with the capacity to support a variety of collaborative, multisite, practice-based investigations related to children born at risk of secondary disability. Specific aims in category II are to (1) conduct a follow-up study in order to describe early outcomes in infants born at dual risk; (2) describe relationships among risk/resilience factors and determinants of positive and negative outcomes for study participants; (3) compare preliminary outcomes for children and families who have received preventive health and developmental follow-up services as an outgrowth of the CUBS network (n=300) with the outcomes of a retrospectively identified comparison group (n=300); (4) establish a data bank and seek additional funding to continue to track the cohort into the educational system in order to describe cost effectiveness of early preventive developmental and health care practices. The CUBS network will enhance capacity of primary care clinicians to use and conduct practice-based research, thus improving the quality of care for infants and children. For young children at dual risk for disability, in particular, the application will provide practitioners with efficacious models for delivering early preventive services in pediatric primary care settings. Study results will provide information crucial for (a) predicting child outcomes, (b) understanding mechanisms by which development is expressed in the child at dual risk, and (c) developing effective prevention and intervention strategies for this vulnerable population.